血清铁蛋白水平与妊娠期糖尿病的相关性研究

目的 探讨孕早期血清铁蛋白水平(SF)与妊娠期糖尿病(GDM)的相关性及对GDM诊断的临床意义.方法 对2015年6月至2017年2月在宜宾市第一人民医院产科门诊行产检并且住院分娩的58例GDM孕妇(GDM组)和同期58例正常对照孕妇(NGT组)的一般资料、孕早期(11~13周)和孕中期(24~28周)SF水平、空腹血糖水平(FPG)、空腹胰岛素(FINS)和胰岛素抵抗指数(HOMA-IR)进行回顾性分析.比较两组孕妇孕早、中期SF水平和HOMA-IR.运用Pearson相关分析孕早、中期SF水平与HOMA-IR的相关性.采用受试者工作(ROC)曲线评估SF在孕早期SF在GDM中的诊断价值.结果 孕早、中期GDM组孕妇SF水平和HOMA-IR高于NGT组(t值为5.472~10.635,均P<0.05);运用Pearson相关分析显示,孕早期SF水平与HOMA-IR呈正相关(r=0.672,P<0.05);孕中期SF水平与HOMA-IR呈正相关(r=0.783,P<0.05);孕早期SF水平对GDM的诊断的曲线下面积(AUC)为0.925.最佳阈值为22.96μg/L,其敏感度为89.26%、特异度为85.97%.Youden指数为0.891,阳性预测值为96.51%,阴性预测值为60.32%.结论 孕早期SF水平变化与GDM的发病相关,孕早期SF水平可能作为早期诊断和预防GDM的血清学指标.

Relationship between serum ferritin and gestational diabetes mellitus

Objective To explore the relationship between serum ferritin (SF) level and gestational diabetes mellitus (GDM) and the clinical significance on GDM diagnosis in early pregnancy .Methods A retrospective study was conducted on the general data , SF levels in early pregnancy (11-13 weeks) and second trimester (24-28 weeks), fasting plasma glucose (FPG), fasting insulin (FINS) and homeostasis model assessment for insulin resistance ( HOMA-IR ) of 58 cases of GDM ( group GDM ) and 58 normal control pregnant women ( group NGT ) examined at the obstetrics clinic and delivering in the First People ' s Hospital of Yibin from June 2015 to February 2017.The levels of SF and HOMA-IR were compared between two groups at early and middle stages of pregnancy .Pearson correlation analysis was used to analyze the correlation between SF levels and HOMA-IR at early and middle stages of pregnancy .The receiver operating curve ( ROC) was used to assess the diagnostic value of SF in early pregnancy in GDM .Results The levels of SF and HOMA-IR in group GDM were higher than those in group NGT at early and middle stages (t value ranged 5.472-10.635, both P<0.05).Pearson correlation analysis showed that SF level in early pregnancy was positively related to HOMA -IR (r=0.672, P<0.05), and the level of SF in the second trimester of pregnancy was also positively correlated with HOMA-IR (r=0.783,P<0.05).At the early stage of pregnancy area under the curve (AUC) of SF level in diagnosis of GDM was 0.925.The optimum threshold was 22.96μg/L, with a sensitivity of 89.26%and a specificity of 85.97%.The Youden index was 0.891, the positive predictive value was 96.51%, and the negative predictive value was 60.32%.Conclusion SF level in early pregnancy is related to the incidence of GDM , and it may be used as a serological marker for the early diagnosis and prevention of GDM .